Risk Manager (Onsite), full time, days

Holland Hospital•Erie, PA

1d•Onsite

About The Position

Works under the supervision of the Director of System Risk Management. Provides primary support throughout the system (including Holland Hospital Medical Groups) for risk management, claims management, and initiatives designed to control and minimize loss and protect the assets of the system. Participates in and collaborates with related quality programs including patient and environmental safety, Patient Relations, performance improvement, regulatory compliance, Infection Control, Corporate Compliance, and patient satisfaction. Manages Patient Relations/Recipient Rights Coordinators and Risk Specialist. Please note that this position is considered onsite with occasional opportunities to work from home.

Requirements

Bachelor’s Degree
General knowledge of regulatory and accreditation standards.
Minimum three to five years clinical experience in an acute-care setting.
Minimum one to two years risk management, regulatory, or quality experience.
Insurance and claims management experience
Management experience
Must be able to build relationships and lead teams, including partnerships with medical staff
Able to facilitate change
Ability to design & present educational programming throughout all organizational levels
Excellent analytical, interpersonal and organizational skills
Able to work on multiple priorities and manage within timeframes
Working knowledge of computer software, e.g. MS Word, Excel, PowerPoint, Access
Bachelors degree

Nice To Haves

Masters degeree in healthcare administration, business administration, or related field preferred.
RN License
CPHRM (Certification in Healthcare Risk Management)
Experience with RL Datix platforms/occurrence reporting systems

Responsibilities

Under the direction of the Director for System Risk Management, provides oversight for System-Wide Risk Management/Patient Safety Programs
Develops, implements, and evaluates the system's risk management/patient safety programs (inclusive of Holland Hospital as well as Holland Hospital Medical Group [HHMG] practices)
Supports staff, administration and medical staff by providing information and advice related to legal, risk management, claims, and patient safety issues
Develops and implements annual strategic plans for the risk management, claims management, and patient safety programs
Annually evaluates the risk management programs and prepares the reports for Board evaluations
Provides supervision and annual evaluation of Risk Specialist
Ensures compliance with and provides advice related to risk management regulatory and legal issues, including MMSEA Section 111, EMTALA, informed consent, Safe Medical Device Act, end-of-life decision making, Section 504/Civil Rights, peer review and peer protection, as well as CMS, DNV, and the Michigan Mental Health Code, as appropriate
Manages the system-wide occurrence reporting process, to include identification of trends or patterns, follow-up and feedback to managers, and reporting to various committees
Recommends risk reduction strategies or risk treatment, as appropriate, in response to occurrences or events
Manages the root cause analysis (RCA), sentinel and adverse event management, and Risk Assessment processes
In conjunction with the Director for System Risk Management, assists administration, medical staff, and hospital Leadership with the development, implementation, and oversight of a comprehensive risk management and patient safety program
Supports various patient safety and performance improvement committees and projects
Identifies and initiates strategies and goals within the patient safety program based on internal data as well as external alerts and information
Coordinates disclosure events, working with physicians and staff on disclosure, documentation, etc., as well as with administration on management of events
Develops and updates documents related to patient safety, such as the Risk Management & Patient Safety Plans, Disclosure Guidelines, and patient safety policies
Coordinates/implements regulatory requirements related to patient safety
Conducts initial and ongoing education with staff and volunteers
Provides guidance and recommendations related to system-wide risk retention/risk transfer processes
Actively participates in the administration of the system Self-Insured Trust as well as the professional/general liability programs
Provides guidance and recommendations related to general/professional liability insurance selection and coverage
Facilitates the insurance procurement process (to include all lines of organizational insurance except for Worker's Compensation insurance), including providing guidance and analysis related to selection and coverage
Oversight of Recipient Rights and Patient Relations Programs
Provides oversight of the development, implementation, and evaluation of the Holland Hospital Recipient Rights and Patient Relations Programs
Provides daily supervision as well as annual evaluation of Patient Relations/Recipient Rights Coordinators
Facilitates coordination and streamlining of Patient Relations and Risk activities and initiatives
Provides oversight of survey readiness and continuous compliance activities relative to the Recipient Rights Program as well as the DNV/CMS Grievance Process
Under the direction of the Director, System Risk Management, Serves as the liaison to the system's insurance carrier(s); works with legal counsel to coordinate the investigation, processing, and defense of claims against the organization as well as employed physicians and HHMG physicians and practices
Manages the system's self-insured trust and excess insurance coverage to include management of all potentially compensable events (PCEs), Notices of Intent (NOIs), and lawsuits
Directs legal counsel relative to management of lawsuits and defense of the hospital/employed staff
Settles claims and PCEs based on settlement authority
Supports the Claims Committee, providing regular updates on legal activity as well as trends/patterns in claims
Manages all subpoenas and search warrants served to the organization/employed staff
Authorizes write-offs and reimbursement for patients as appropriate
Maintains a historical database and accurate files on PCEs, NOIs, and lawsuits
Works collaboratively with all areas of the organization to assure system -wide integration of risk management program
Supports clinical areas and physician practices through clinical risk management activities such as focused risk assessments, education, special projects, and event management
Creates and revises policies and forms to ensure legal protection
Provides initial and ongoing education for staff, volunteers, and physicians related to risk management and patient safety
Integrates the risk management program with other key system programs/services, including clinical services, Utilization Management, and Patient Relations
Participates, as appropriate, with medical staff peer review, credentialing, and other medical staff functions related to standards of care and competency
Provides education and training for staff, leadership, medical staff, and the Boards related to areas of responsibility
Conducts initial and ongoing risk management and patient safety education with new and existing employees, volunteers, and medical staff
Identifies topics for presentation to the medical staff and existing staff related to risk management, clinical risk issues, and patient safety; presents material or identifies external speakers
Recommends educational topics to leadership staff, medical staff, and the Hospital clinical education team, as appropriate
Conducts education related to specific risk management requirements as well as new/revised processes (e.g. occurrence reports)